Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Matt Domico LCSW LLC

Organization Adult Mental Health Clinic/Center · NPI 1962294629

Matt Domico LCSW LLC is an Adult Mental Health Clinic/Center in Peoria, Illinois. Registered with an NPI since 2025.

In the registry since
2025
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

5901 N Prospect Rd Ste 105
Peoria, IL 61614-4358
Phone: (815) 701-6317
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Adult Mental Health Clinic/Center (primary) Taxonomy 261QM0850X

Record details

NPI number1962294629
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Matt Domico — Ceo · (815) 701-6317
NPI enumeratedMay 20, 2025
Last updated in NPPESMay 20, 2025
Certification dateMay 20, 2025
Mailing address5901 N Prospect Rd Ste 105, Peoria, IL 61614-4358

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