Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Shawn Rae Disterhaupt

Individual provider Clinical Social Worker · NPI 1942996087

Shawn Rae Disterhaupt is a Clinical Social Worker in Brainerd, Minnesota. Licensed in Minnesota. Registered with an NPI since 2023.

Licensed in
MN
In the registry since
2023

Practice location Address checks out

606 Frnt ST
Brainerd, MN 56401-3602
Phone: (218) 232-6247
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 26111 (MN)

Record details

NPI number1942996087
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedApril 12, 2023
Last updated in NPPESApril 12, 2023
Certification dateApril 12, 2023

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