# ARIZONA FAMILY TRAUMA CENTER

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Arizona Trauma Family Center, Arizona Family Trauma Center, Family Trauma Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1528809589
- **Authorized official:** BRIAN TIMOTHY LONGWORTH (MD)
- **Authorized official phone:** (480) 318-6688

## Contact information

- **Practice address:** 15901 W WADDELL RD APT 1124, SURPRISE, AZ 85379-0023
- **Practice address phone:** (480) 318-6688
- **Mailing address:** 15901 W WADDELL RD APT 1124, SURPRISE, AZ 85379-0023
- **Mailing address phone:** (480) 318-6688

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | — | NULL | Yes |
| 101YM0800X | Mental Health Counselor | — | — | Yes |

## Other

- **Enumeration date:** 06/04/2024
- **Last updated:** 09/03/2026