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PROVISO-LEYDEN COUNCIL FOR COMMUNITY ACTION INC
NPI 1306653613
Clinic/Center - Adult Mental Health in Maywood, IL

Active since December 11, 2024
411 MADISON ST, MAYWOOD, IL 60153(708) 450-3500(708) 236-5184 Get Directions Write a Review

NPPES record last updated: April 21, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Apr 21, 2026, Apr 17, 2026, Dec 11, 2024 (3 updates tracked since 2024).

About Proviso-leyden Council For Community Action Inc NPPES

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

PROVISO-LEYDEN COUNCIL FOR COMMUNITY ACTION INC (NPI 1306653613), doing business as Plcca, is a healthcare organization registered as an adult mental health in Maywood, Illinois and active in the NPI registry since December 2024. The organization lists Jacob Aloor Mathew, Board Member, as its authorized official.

NPPES Registry Identity

NPI1306653613
Entity TypeOrganization
Primary Taxonomy261QM0850X
Legal Business NamePROVISO-LEYDEN COUNCIL FOR COMMUNITY ACTION INC
Location Address411 MADISON STMaywood, IL 60153-2136
Mailing Address411 Madison StMaywood, IL 60153-2136 · (708) 450-3500 · Fax (708) 236-5184
Phone(708) 450-3500
Fax(708) 236-5184
Organization SubpartNo
Authorized OfficialJacob Aloor MathewBoard Member · (708) 632-5610
Enumeration DateDecember 11, 2024
Last NPPES UpdateApril 21, 20263 updates tracked since enumeration
NPPES CertifiedApril 21, 2026
✔ NPI 1306653613 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyClinic/Center · Adult Mental HealthAmbulatory Health Care Facilities
Taxonomy Code261QM0850X
Definition
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults.
Also ListedClinic/Center · Adolescent and Children Mental HealthTaxonomy 261QM0855X
411 MADISON ST, Maywood, IL 60153
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Other Names 1

Doing Business AsPlcca

Other Providers at the Same Location NPPES 8

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JAKE CLIFTON KELOW III LSW/CADC/ATE/COPD I
Social Worker (Clinical)
411 MADISON ST
MAYWOOD, IL 60153
Cook County (708) 450-3500
PROVISO-LEYDEN COUNCIL FOR COMMUNITY ACTION INC
Clinic/Center (Methadone)
411 MADISON ST
MAYWOOD, IL 60153
Cook County (708) 236-5042
PLCCA, INC.
Contractor
411 MADISON ST
MAYWOOD, IL 60153
Cook County (708) 236-5038
MR. ANTONY D GREENHOW MS, LPC, NCC
Counselor
411 MADISON ST
MAYWOOD, IL 60153
Cook County (708) 450-3500
PLCCA,INC.
Community/Behavioral Health
411 MADISON ST
MAYWOOD, IL 60153
Cook County (708) 450-3500
MS. JANET TAPIA LICENSE SOCIAL WORK
Counselor (Mental Health)
411 MADISON ST
MAYWOOD, IL 60153
Cook County (708) 450-3500
MS. MINDY ANN HERMANN I MSW LSW
Social Worker
411 MADISON ST
MAYWOOD, IL 60153
Cook County (773) 450-3500
PROVISO LEYDEN COUNCIL FOR COMMUNITY ACTION
Community/Behavioral Health
411 MADISON ST
MAYWOOD, IL 60153
Cook County (708) 450-3500

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 Proviso-Leyden Council For Community Action Inc's NPI number?

The NPI number for Proviso-Leyden Council For Community Action Inc is 1306653613. It was assigned to this organization in the NPPES registry on December 11, 2024. The provider is doing business as Plcca.

Where is Proviso-Leyden Council For Community Action Inc located?

Proviso-Leyden Council For Community Action Inc is located at 411 Madison St, Maywood, IL 60153. The listed phone number is (708) 450-3500.

What is Proviso-Leyden Council For Community Action Inc's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Adult Mental Health, with taxonomy code 261QM0850X.

When was this NPI record last updated?

The NPPES record for Proviso-Leyden Council For Community Action Inc was last updated on April 21, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.