Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
SHAWN RAE DISTERHAUPT
ActiveSHAWN RAE DISTERHAUPT is a Clinical Social Worker healthcare provider located in BRAINERD, Minnesota. NPI 1942996087 is currently active in the NPPES registry. Verify at CMS.
Clinical Social Worker · BRAINERD, MN
Registration Details
- NPI Number
- 1942996087
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Apr 12, 2023 (3.3177530573255 yrs)
- Last Updated
- Apr 12, 2023
- License
-
26111 (MN)
Practice Information
- Address
-
606 FRONT STBRAINERD, MN, 564013602Browse MN providers · Browse ZIP 56401
- Phone
- 2182326247
- Primary Specialty
-
Clinical Social Worker
1041C0700X
Other Clinical Social Worker Providers in BRAINERD, MN
| Name | Credential | NPI |
|---|---|---|
| PHILIP B TANGE | MSW | 1710992698 |
| MS. REBECCA ANN BONTJES | MSW, LICSW | 1275648453 |
| MISS BARBARA KAY PARKS | MED, LICSW | 1013083344 |
| LAURA J. SKOGEN | M.S.W. | 1164599767 |
| MS. PAM L FORE | LICSW | 1861533630 |
| MR. STUART JAMES POPKIN | L.I.C.S.W. | 1386774610 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.