NPIMap

Organization Active NPI

Southwest Network

  • Community/Behavioral Health Agency
  • Phoenix, AZ
National Provider Identifier
1104856004
Registry record updated Jan 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
OTC6258 Issued in AZ
Legal business name
SOUTHWEST NETWORK
Practice address
120 N 44TH St Ste 400
Phoenix, AZ 85034-1822
Phone
(602) 304-0014
Fax
(602) 304-0190
NPI assigned
Jul 4, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Amy B. Henning
Title
Ceo
Phone
(602) 285-4340

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X OTC6258 AZ
Community/Behavioral Health Agency 251S00000X OTC6258 AZ Primary

Addresses

Primary practice location

120 N 44TH St Ste 400
Phoenix, AZ 85034-1822

Mailing address

2700 N Central Ave
Suite 1050
Phoenix, AZ 85004-1133
Phone (602) 266-8402

Other practice location 1

2444 E University Dr Ste 150
Phoenix, AZ 85034-6934
Phone (602) 304-0014

Other identifiers 2

IdentifierTypeStateIssuer
545246MedicaidAZ
Z127516OtherAZMEDICARE PTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070613000698 AZ Part B Supplier - Clinic/Group Practice 2567560659 Receives reassigned benefits from 43 practitioners
12 other NPIs on this enrollment
Practice locations: Phoenix, AZ; Peoria, AZ; Chandler, AZ

Other NPIs on the same Medicare enrollment 7

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

2444 E University Dr
Phoenix, AZ 85034

2444 E University Dr
Ste 150
Phoenix, AZ 85034
Phone (602) 304-0014

120 N 44th St
Ste 400
Phoenix, AZ 85034
Phone (602) 304-0014

Practitioners & affiliated clinicians

Practitioners 48

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 48

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1769644800000",
    "number": "1104856004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 N CENTRAL AVE",
            "address_2": "SUITE 1050",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850041133",
            "telephone_number": "602-266-8402",
            "fax_number": "602-264-0887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 N 44TH ST STE 400",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850341822",
            "telephone_number": "602-304-0014",
            "fax_number": "602-304-0190"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2444 E University Dr Ste 150",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850346934",
            "country_code": "US",
            "telephone_number": "602-304-0014",
            "fax_number": "602-304-0190",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SOUTHWEST NETWORK",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-04",
        "last_updated": "2026-01-29",
        "certification_date": "2026-01-29",
        "status": "A",
        "authorized_official_last_name": "HENNING",
        "authorized_official_first_name": "AMY",
        "authorized_official_middle_name": "B.",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "602-285-4340"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "AZ",
            "license": "OTC6258",
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "AZ",
            "license": "OTC6258",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "545246",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "Z127516",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.