Provider Demographics
NPI:1063918811
Name:CHERESE M. ALCORN, M.S.W., L.C.S.W., LLC
Entity type:Organization
Organization Name:CHERESE M. ALCORN, M.S.W., L.C.S.W., LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED CLINICAL SOCIAL WORKER
Authorized Official - Prefix:
Authorized Official - First Name:CHERESE
Authorized Official - Middle Name:M
Authorized Official - Last Name:ALCORN
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LCSW
Authorized Official - Phone:314-556-0009
Mailing Address - Street 1:7750 CLAYTON RD STE 312
Mailing Address - Street 2:
Mailing Address - City:RICHMOND HEIGHTS
Mailing Address - State:MO
Mailing Address - Zip Code:63117-1341
Mailing Address - Country:US
Mailing Address - Phone:314-556-0009
Mailing Address - Fax:314-492-0095
Practice Address - Street 1:7750 CLAYTON RD STE 312
Practice Address - Street 2:
Practice Address - City:RICHMOND HEIGHTS
Practice Address - State:MO
Practice Address - Zip Code:63117-1341
Practice Address - Country:US
Practice Address - Phone:314-556-0009
Practice Address - Fax:314-492-0095
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-02
Last Update Date:2021-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)