Corette Marie Gardner, LSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

150.117490 Issued in IL

Practice address

2205 State St
Pekin, IL 61554-3936

Phone

(309) 648-0782

NPI assigned

Aug 18, 2025

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Edgewood Clinical Services, P.C.

  • Psychologist
  • Naperville, IL
  • NPI 1295914646
  NPD

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

{
    "created_epoch": "1755475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755475200000",
    "number": "1275410979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1017 S MERCER AVE APT 328",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617017183",
            "telephone_number": "828-269-8330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2205 STATE ST",
            "city": "PEKIN",
            "state": "IL",
            "postal_code": "615543936",
            "telephone_number": "309-648-0782"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARDNER",
        "first_name": "CORETTE",
        "middle_name": "MARIE",
        "credential": "LSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-08-18",
        "last_updated": "2025-08-18",
        "certification_date": "2025-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "ME",
            "license": "LM19322",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IL",
            "license": "150.117490",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Friedrich J. Von Bun, M.D.,S.C.
• Laura Christine Fuelberth, RD
• Michael Duane Funk, DC
• Karsen Elaine Fussner, COTA/L
• Anu Ganesh
• Gateway Professional Services, PC
• Judy C Getz, RD, BS, LD
• Jessica Gheewala, PA-C
• Molly Rose Giamette, MA, LPC
• GK Enterprise LLC

• Social Worker in Pekin, IL
• Providers in Pekin, IL by specialty
• Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 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.