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

Proviso-Leyden Council for Community Action Inc

Organization Adult Mental Health Clinic/Center · NPI 1306653613

Proviso-Leyden Council for Community Action Inc is an Adult Mental Health Clinic/Center in Maywood, Illinois. Registered with an NPI since 2024.

In the registry since
2024
Specialties on file
2
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

411 Madison St
Maywood, IL 60153-2136
Phone: (708) 450-3500
Fax: (708) 236-5184
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Adult Mental Health Clinic/Center (primary) Taxonomy 261QM0850X
Adolescent and Children Mental Health Clinic/Center Taxonomy 261QM0855X

Record details

NPI number1306653613
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jacob Mathew — Board Member · (708) 632-5610
Other names Plcca
NPI enumeratedDecember 11, 2024
Last updated in NPPESApril 21, 2026
Certification dateApril 21, 2026
Mailing address411 Madison St, Maywood, IL 60153-2136

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