Healthcare Provider Details

I. General information

NPI: 1134652803
Provider Name (Legal Business Name): CLARISSA ELIZABETH HARWELL LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/09/2017
Last Update Date: 08/08/2025
Certification Date: 08/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 N MARKET ST STE 300
SAN JOSE CA
95113-1211
US

IV. Provider business mailing address

2 NORTH MARKET ST
SAN JOSE CA
95113
US

V. Phone/Fax

Practice location:
  • Phone: 510-210-3233
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number92663
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: