Active NPI
Jake Carman
- Professional Counselor
- Springfield, IL
National Provider Identifier
1912849704
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- NCC2527016
- Practice address
- 4481 Ash Grove Dr Ste B
Springfield, IL 62711-6359 - Phone
- (847) 809-2669
- NPI assigned
- Apr 8, 2026
- Last updated
- Apr 8, 2026
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | NCC2527016 | IL | Primary |
Addresses
Primary practice location
4481 Ash Grove Dr Ste B
Springfield, IL 62711-6359
Mailing address
728 W Woodland Ave
Springfield, IL 62704-2837
Phone (847) 809-2669
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| NCC2527016 | IL | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1775606400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1775606400000",
"number": "1912849704",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "728 W WOODLAND AVE",
"city": "SPRINGFIELD",
"state": "IL",
"postal_code": "627042837",
"telephone_number": "847-809-2669"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4481 ASH GROVE DR STE B",
"city": "SPRINGFIELD",
"state": "IL",
"postal_code": "627116359",
"telephone_number": "847-809-2669"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARMAN",
"first_name": "JAKE",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2026-04-08",
"last_updated": "2026-04-08",
"certification_date": "2026-04-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "IL",
"license": "NCC2527016",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Springfield, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.