OrganizationActive
Matt Domico Lcsw LLC
NPI 1962294629 · Adult Mental Health Clinic/Center · Peoria, IL
Provider details
- NPI number
- 1962294629
- Entity type
- Organization
- Primary specialty
- Adult Mental Health Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Matt Domico, Ceo(815) 701-6317
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
Established profile(54/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
1 yr in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
5901 N Prospect Rd Ste 105
Peoria, IL 61614-4358
Phone: (815) 701-6317
Street-level locationGet directions
Mailing address
5901 N Prospect Rd Ste 105
Peoria, IL 61614-4358
Registry dates
- Enumerated
- 2025-05-20
- Last updated
- 2025-05-20
- Certified
- 2025-05-20
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.