Provider Demographics
NPI:1295832897
Name:TRAFTON, SUSAN KAY (EDD)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:KAY
Last Name:TRAFTON
Suffix:
Gender:F
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 99
Mailing Address - Street 2:
Mailing Address - City:CASCADE
Mailing Address - State:WI
Mailing Address - Zip Code:53011-0099
Mailing Address - Country:US
Mailing Address - Phone:414-462-8979
Mailing Address - Fax:
Practice Address - Street 1:2169 N 53RD ST
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53208-1008
Practice Address - Country:US
Practice Address - Phone:414-305-7496
Practice Address - Fax:262-364-2424
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-19
Last Update Date:2025-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1764-057103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI40964700Medicaid