Healthcare Provider Details

I. General information

NPI: 1952220550
Provider Name (Legal Business Name): KASEY CLAYTON SUMMERER
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/15/2026
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 W NORFOLK AVE STE 201
NORFOLK NE
68701-5221
US

IV. Provider business mailing address

85052 495TH AVE
EWING NE
68735-5324
US

V. Phone/Fax

Practice location:
  • Phone: 402-379-2030
  • Fax: 402-379-3933
Mailing address:
  • Phone: 214-864-5333
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: