IndividualActive
Jacob Holthoff
NPI 1063150175 · Professional Counselor · Champaign, IL
Provider details
- NPI number
- 1063150175
- Entity type
- Individual
- Primary specialty
- Professional CounselorBehavioral Health & Social Service Providers
- Sex
- Male
- Sole proprietor
- Yes
- License
- 178018951 (IL)
Specialties & taxonomies
Behavioral Health & Social Service Providers
Profile Score
Established profile(65/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
4 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
2 documented practice locations
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
201 W Springfield Ave Ste 1201
Champaign, IL 61820-6385
Phone: (217) 722-9079
Fax: (217) 501-4322
Approximate (ZIP-level) locationGet directions
Mailing address
201 W Springfield Ave Ste 1201
Champaign, IL 61820-6385
Additional practice locations (1)
- 1612 Patton DrMahomet, IL 61853-8157Phone: (217) 590-4178Fax: (217) 501-4322
Registry dates
- Enumerated
- 2022-05-27
- Last updated
- 2025-01-18
- Certified
- 2025-01-18
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.