Individual
MR. KENNETH ALCORN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
965 S HIGHWAY 25 W, WILLIAMSBURG, KY 40769-1608
(606) 549-2656
Mailing address
PO BOX 540, JELLICO, TN 37762-0540
(423) 784-8492
(423) 784-8358
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
094954
NY
1041C0700X
Clinical Social Worker
Primary
8508
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
258700
KY LICENSE
KY
01
—
8508
TN LICENSE
TN
Enumeration date
06/16/2015
Last updated
06/05/2024
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