Provider Demographics
NPI:1770222119
Name:CASSANO, HARISA (LICSW)
Entity Type:Individual
Prefix:
First Name:HARISA
Middle Name:
Last Name:CASSANO
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:HARISA
Other - Middle Name:
Other - Last Name:PACO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LICSW
Mailing Address - Street 1:20200 54TH AVE W
Mailing Address - Street 2:
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98036-6318
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:201 16TH AVE E
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98112-5226
Practice Address - Country:US
Practice Address - Phone:206-326-4545
Practice Address - Fax:206-326-4555
Is Sole Proprietor?:No
Enumeration Date:2022-06-02
Last Update Date:2023-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW609825071041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical