Individual provider Active NPI

Samanda Bryant Hagan, PHD, LCSW, MDIV

  • Clinical Social Worker
  • Jbsa Lackland, TX
National Provider Identifier
1285058024
Registry record updated Jul 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
66118 Issued in TX
Practice address
1100 Wilford Hall Loop, BLDG 4554
Attn: 59 MDW/SGHC
Jbsa Lackland, TX 78236
Phone
(210) 292-6225
NPI assigned
Feb 14, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X
Clinical Social Worker 1041C0700X 66118 TX Primary

Addresses

Primary practice location

1100 Wilford Hall Loop, BLDG 4554
Attn: 59 MDW/SGHC
Jbsa Lackland, TX 78236

Mailing address

1100 Wilford Hall Loop BLDG 4554
Jbsa Lackland, TX 78236-5638
Phone (210) 292-7361

Other practice location 1

4538 Centerview Ste 180
San Antonio, TX 78228-1319
Phone (726) 201-5284

Other practice location 2

3551 Roger Brooke Dr
Fort Sam Houston, TX 78234-4504
Phone (210) 916-5047

Other practice location 3

Psc 851 Box 340
Fpo, AE 09834-0004
Phone (318) 439-9545

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
66118TXMDCounselor

NPI Registry JSON

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

{
    "created_epoch": "1392336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753747200000",
    "number": "1285058024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 WILFORD HALL LOOP BLDG 4554",
            "city": "JBSA LACKLAND",
            "state": "TX",
            "postal_code": "782365638",
            "telephone_number": "210-292-7361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 WILFORD HALL LOOP, BLDG 4554",
            "address_2": "ATTN: 59 MDW/SGHC",
            "city": "JBSA LACKLAND",
            "state": "TX",
            "postal_code": "78236",
            "telephone_number": "210-292-6225"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4538 Centerview Ste 180",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782281319",
            "country_code": "US",
            "telephone_number": "726-201-5284",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3551 Roger Brooke Dr",
            "address_purpose": "LOCATION",
            "city": "Fort Sam Houston",
            "state": "TX",
            "postal_code": "782344504",
            "country_code": "US",
            "telephone_number": "210-916-5047",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "Psc 851 Box 340",
            "address_purpose": "LOCATION",
            "city": "FPO",
            "state": "AE",
            "postal_code": "098340004",
            "country_code": "US",
            "telephone_number": "318-439-9545",
            "country_name": "United States",
            "address_type": "MIL"
        }
    ],
    "basic": {
        "last_name": "BRYANT HAGAN",
        "first_name": "SAMANDA",
        "name_prefix": "Dr.",
        "credential": "PHD, LCSW, MDIV",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-02-14",
        "last_updated": "2025-07-29",
        "certification_date": "2025-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "66118",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jbsa Lackland, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 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.