PROJECT VIDA, INC.
NPI 1285167577
Social Worker - Clinical in Chicago, IL

Active since April 04, 2017CLIA 14D1023970 · Waiver
2659 S KEDVALE AVE, CHICAGO, IL 60623(773) 277-2291 Get Directions Write a Review

NPPES record last updated: April 4, 2017. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Project Vida, Inc. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PROJECT VIDA, INC. (NPI 1285167577) is a healthcare organization registered as a clinical in Chicago, Illinois and active in the NPI registry since April 2017. The organization holds a CLIA Waiver certificate valid through March 29, 2028 and lists Jerome Montgomery, Executive Director, as its authorized official.

NPPES Registry Identity

NPI1285167577
Entity TypeOrganization
Primary Taxonomy1041C0700X
Legal Business NamePROJECT VIDA, INC.
Location Address2659 S KEDVALE AVEChicago, IL 60623-4322
Mailing Address2659 S Kedvale AveChicago, IL 60623-4322 · (773) 277-2291
Organization SubpartNo
Authorized OfficialJerome MontgomeryExecutive Director · (773) 277-2291
Enumeration DateApril 4, 2017
NPI 1285167577 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 6

Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
Definition
A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
Also ListedCounselorTaxonomy 101Y00000X
Also ListedCounselor · Mental HealthTaxonomy 101YM0800X
Also ListedSocial WorkerTaxonomy 104100000X
2659 S KEDVALE AVE, Chicago, IL 60623

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 14D1023970

Project Vida Inc · Chicago, IL
Active · expires Mar 29, 2028
CLIA Number14D1023970
Laboratory TypeOther
Certificate Effective DateMarch 30, 2026
Certificate Expiration DateMarch 29, 2028
Laboratory DirectorMichael Henderson
Laboratory Phone(773) 522-4570
Laboratory LocationProject Vida Inc2659 S Kedvale Ave, Chicago, IL 60623
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Project Vida, Inc.'s NPI number?

The NPI number for Project Vida, Inc. is 1285167577. It was assigned to this organization in the NPPES registry on April 4, 2017.

Where is Project Vida, Inc. located?

Project Vida, Inc. is located at 2659 S Kedvale Ave, Chicago, IL 60623. The listed phone number is (773) 277-2291.

What is Project Vida, Inc.'s specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Does Project Vida, Inc. hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 14D1023970) is associated with this NPI, valid through March 29, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Project Vida, Inc. was last updated on April 4, 2017. NPI Profile syncs with the weekly NPPES data releases published by CMS.