Organization Active NPI

Headlight Mental Healthcare PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Phoenix, AZ
National Provider Identifier
1861240202
Registry record updated Jul 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
HEADLIGHT MENTAL HEALTHCARE PLLC
Practice address
2 N Central Ave Ste 1800
Phoenix, AZ 85004-2139
Phone
(480) 618-7023
Fax
(480) 781-4866
NPI assigned
May 10, 2024
Last updated
Jul 9, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2025

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

Authorized official

Name
Matthew Laird, PMHNP-BCNPI 1619683224
Title
Founder
Phone
(480) 618-7023

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X NU Primary

Addresses

Primary practice location

2 N Central Ave Ste 1800
Phoenix, AZ 85004-2139

Mailing address

2 N Central Ave Ste 1800
Phoenix, AZ 85004-2139
Phone (480) 618-7023

Other practice location 1

555 SE Mlk Blvd Unit 105
Portland, OR 97214-2595
Phone (541) 581-1080

Other identifiers 1

IdentifierTypeStateIssuer
500816462MedicaidOR

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1715299200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1752019200000",
    "number": "1861240202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 N CENTRAL AVE STE 1800",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850042139",
            "telephone_number": "480-618-7023",
            "fax_number": "480-781-4866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 N CENTRAL AVE STE 1800",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850042139",
            "telephone_number": "480-618-7023",
            "fax_number": "480-781-4866"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "555 SE Mlk Blvd Unit 105",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972142595",
            "country_code": "US",
            "telephone_number": "541-581-1080",
            "fax_number": "541-588-6525",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "HEADLIGHT MENTAL HEALTHCARE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-10",
        "last_updated": "2025-07-09",
        "certification_date": "2025-06-24",
        "status": "A",
        "authorized_official_last_name": "LAIRD",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "FOUNDER",
        "authorized_official_telephone_number": "480-618-7023",
        "authorized_official_credential": "PMHNP-BC"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500816462",
            "state": "OR"
        }
    ],
    "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 Jul 9, 2025; 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.