Healthcare Provider Details

I. General information

NPI: 1215618780
Provider Name (Legal Business Name): SUMMER KRASKA PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SUMMER LARDY

II. Dates (important events)

Enumeration Date: 07/27/2023
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3221 32ND AVE S
GRAND FORKS ND
58201-6071
US

IV. Provider business mailing address

416 25TH AVE S
GRAND FORKS ND
58201-7432
US

V. Phone/Fax

Practice location:
  • Phone: 320-292-5959
  • Fax:
Mailing address:
  • Phone: 320-292-5959
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number1003
License Number StateND

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: