NPIMap

Individual provider Active NPI

Erin Kathleen Immken, LPC, LCPC

  • Professional Counselor
  • Glen Carbon, IL
National Provider Identifier
1679728356
Registry record updated Jun 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
180.006806 Issued in IL
Practice address
98 Junction Drive West
Suite 6
Glen Carbon, IL 62034
Phone
(618) 710-4123
Fax
(618) 731-4082
NPI assigned
Nov 24, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 2008034953 MO
Professional Counselor 101YP2500X 180.006806 IL Primary

Addresses

Primary practice location

98 Junction Drive West
Suite 6
Glen Carbon, IL 62034

Mailing address

PO Box 98
Edwardsville, IL 62025-0098
Phone (618) 710-4123

Other practice location 1

1 Bronze Pointe Blvd Ste 1
Swansea, IL 62226-1045
Phone (877) 381-6538

Other names 1

  • Erin Kathleen Bostick Former name

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

LicenseStateTypeSpecialty
180.006806ILMDProfessional Counselor
2008034953MOMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Il Institute of Behavioral Health PC Professional Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1227484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749600000000",
    "number": "1679728356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 98",
            "city": "EDWARDSVILLE",
            "state": "IL",
            "postal_code": "620250098",
            "telephone_number": "618-710-4123",
            "fax_number": "618-731-4082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "98 JUNCTION DRIVE WEST",
            "address_2": "SUITE 6",
            "city": "GLEN CARBON",
            "state": "IL",
            "postal_code": "62034",
            "telephone_number": "618-710-4123",
            "fax_number": "618-731-4082"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Bronze Pointe Blvd Ste 1",
            "address_purpose": "LOCATION",
            "city": "Swansea",
            "state": "IL",
            "postal_code": "622261045",
            "country_code": "US",
            "telephone_number": "877-381-6538",
            "fax_number": "618-234-0127",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IMMKEN",
        "first_name": "ERIN",
        "middle_name": "KATHLEEN",
        "credential": "LPC, LCPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-11-24",
        "last_updated": "2025-06-11",
        "certification_date": "2025-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MO",
            "license": "2008034953",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180.006806",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ERIN",
            "last_name": "BOSTICK",
            "middle_name": "KATHLEEN",
            "credential": "LPC, LCPC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Glen Carbon, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.