Provider Demographics
NPI:1316433097
Name:ALCORN, JESSE ALBERT/SHERMAN (MS PCLC, ACLC)
Entity type:Individual
Prefix:MR
First Name:JESSE
Middle Name:ALBERT/SHERMAN
Last Name:ALCORN
Suffix:
Gender:M
Credentials:MS PCLC, ACLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1643 24TH ST W STE 210
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59102-2677
Mailing Address - Country:US
Mailing Address - Phone:406-413-1205
Mailing Address - Fax:
Practice Address - Street 1:1643 24TH ST. W. SUITE 210
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59102
Practice Address - Country:US
Practice Address - Phone:406-413-1205
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-06
Last Update Date:2023-05-31
Deactivation Date:2022-07-20
Deactivation Code:
Reactivation Date:2023-05-25
Provider Licenses
StateLicense IDTaxonomies
MTBBH-PCLC-LIC-56949101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health