Rena M Glass-Dixon, PHD, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CSW004345 Issued in GA

Practice address

990 Iris Dr SW Ste 103
Conyers, GA 30094-6602

Phone

(770) 369-9984

Fax

(770) 369-9984

NPI assigned

Sep 30, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

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.

• Streams of Life Counseling and Educational Services, LLC

  • Clinical Social Worker
  • Conyers, GA
  • NPI 1588295323
  NPD Authorized official

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

{
    "created_epoch": "1538265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580342400000",
    "number": "1104301670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 82653",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300139439",
            "telephone_number": "404-388-7981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "990 IRIS DR SW STE 103",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300946602",
            "telephone_number": "770-369-9984",
            "fax_number": "770-369-9984"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLASS-DIXON",
        "first_name": "RENA",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "PHD, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-09-30",
        "last_updated": "2020-01-30",
        "certification_date": "2020-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW004345",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF GEORGIA CLINICAL SOCIAL WORKER",
            "identifier": "CSW004345",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Latonya F. R. Gillespie, D.D.S.
• Tamara Gilliam
• Manon M Girard, SLP
• Chandra Girdhari, CRNA
• Rodney L Givens, DDS
• Glaze and Allen Van Lift Inc (R&R Van Lift Sales and Service)
• Glazed Skin Studio LLC
• Magdalene Tiah Glekiah, NP
• Glo Connect LLC
• Global Diagnostic Services, Inc.

• Clinical Social Worker in Conyers, GA
• Providers in Conyers, GA by specialty
• Clinical Social Worker in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2020; 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.