NPIMap

Organization Active NPI

Arizona Family Trauma Center

Doing business as Family Trauma Center

  • Mental Health Counselor
  • Surprise, AZ
National Provider Identifier
1528809589
Registry record updated Sep 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
ARIZONA FAMILY TRAUMA CENTER
Doing business as
Arizona Family Trauma Center
Family Trauma Center
Practice address
15901 W Waddell Rd Apt 1124
Surprise, AZ 85379-0023
Phone
(480) 318-6688
NPI assigned
Jun 4, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2026

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

Authorized official

Name
Brian Timothy LongworthNPI 1295096907
Title
MD
Phone
(480) 318-6688

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

15901 W Waddell Rd Apt 1124
Surprise, AZ 85379-0023

Mailing address

15901 W Waddell Rd Apt 1124
Surprise, AZ 85379-0023
Phone (480) 318-6688

Other names 2

  • Arizona Family Trauma Center Doing business as
  • Family Trauma Center Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1717459200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1788393600000",
    "number": "1528809589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15901 W WADDELL RD APT 1124",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853790023",
            "telephone_number": "480-318-6688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15901 W WADDELL RD APT 1124",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853790023",
            "telephone_number": "480-318-6688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARIZONA FAMILY TRAUMA CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-04",
        "last_updated": "2026-09-03",
        "certification_date": "2026-09-03",
        "status": "A",
        "authorized_official_last_name": "LONGWORTH",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "TIMOTHY",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "480-318-6688"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Arizona Family Trauma Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Family Trauma Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Surprise, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.