SAMANDA BRYANT HAGAN (NPI# 1285058024) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285058024 |
| Entity Type | Individual |
| Full Name | SAMANDA BRYANT HAGAN |
| Credential | LICSW, MDIV |
| Practice Address |
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 |
| Practice Telephone | 2102926225 |
| Mailing Telephone | 4046306844 |
| Enumeration Date | 2014-02-14 |
| Last Update Date | 2020-05-07 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
Behavioral Health & Social Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| Psc 851 Box 340, Fpo, AE 098340004 | 3184399545 | |
| 3551 Roger Brooke Dr, Fort Sam Houston, TX 782344504 | 2109165047 |
| Street Address |
1100 WILFORD HALL LOOP, BLDG 4554 ATTN: 59 MDW/SGHC |
| City | JBSA LACKLAND |
| State | TX |
| Zip Code | 78236 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508858176 | Craig Harding Rhyne Jr. | Dentist | 1100 Wilford Hall Loop, Bldg 4554, Attn: 59 Mdw, Jbsa Lackland, TX 78236-9908 | 2005-08-18 |
| 1972132595 | Samantha Nicole Rowden | Student in an Organized Health Care Education/Training Program | 1100 Wilford Hall Loop, Bldg 4554, 59 Mdw/gme, Jbsa Lackland, TX 78236-9908 | 2020-04-06 |
| 1093340176 | Dakota Tomasini | Student in an Organized Health Care Education/Training Program | 1100 Wilford Hall Loop, Bldg 4554, 59 Mdw/gme, Jbsa Lackland, TX 78236-9908 | 2020-03-09 |
| 1679139877 | Benjamin Wang | Dentist | 1100 Wilford Hall Loop, Bldg 4554, Attn: 59 Mdw/sghc, Jbsa Lackland, TX 78236 | 2019-05-13 |
| 1295294478 | Adriana Zamora | Student in an Organized Health Care Education/Training Program | 1100 Wilford Hall Loop, Bldg 4554, 59 Mdw/gme, Jbsa Lackland, TX 78236-9908 | 2019-03-18 |
| 1255899035 | Emma Prichard | Student in an Organized Health Care Education/Training Program | 1100 Wilford Hall Loop, Bldg 4554, 59 Mdw/gme, Jbsa Lackland, TX 78236-9908 | 2019-03-11 |
| 1083117584 | Kevin Fluckiger | Podiatrist | 1100 Wilford Hall Loop, Bldg 4554, Attn: 59 Mdw/sghc, Jbsa Lackland, TX 78236-9908 | 2018-03-12 |
| 1861907453 | Eric Daniel Sanchez | Physical Therapist | 1100 Wilford Hall Loop, Bldg 4554, Attn: 59 Mdw/sghc, Jbsa Lackland, TX 78236-9908 | 2017-12-05 |
| 1528571650 | Holly Johnson | Social Worker | 1100 Wilford Hall Loop, Bldg 4554, Attn: 59 Mdw/sghc, Jbsa Lackland, TX 78236 | 2017-11-11 |
| 1750804845 | Marcela Land | Dentist | 1100 Wilford Hall Loop, Bldg 4554, Jbsa Lackland, TX 78236 | 2017-07-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063047363 | Arnoldo Arturo Gonzalez Jr. | Specialist/Technologist | 1033 Truemper St, Lackland Afb, TX 78236 | 2020-03-06 |
| 1023643343 | Meredith Grace Cockerell | Specialist/Technologist | W Military Drive, San Antonio, TX 78236 | 2020-03-06 |
| 1578120598 | Hali Rashelle Hall | Dentist | 1615 Truemper St, Blg 6418, Attn: 59ds/sgdn, Jbsa Lackland, TX 78236 | 2019-05-24 |
| 1952967077 | Paul Fianza Boseman | Nurse Practitioner | 1106 Wilford Hall Loop, San Antonio, TX 78236 | 2019-05-14 |
| 1689161978 | Kelly Jones Buckshire | Dentist | Dunn Dental Clinic, 1615 Truemper Rd, San Antonio, TX 78236 | 2018-04-23 |
| 1902308570 | Roger Louis Farney | Student in an Organized Health Care Education/Training Program | 1100 Wilford Hall Loop Bldg. 4554, Jbsa Lackland Afb, TX 78236 | 2018-02-28 |
| 1568916856 | Thomas Maxwell Woolf | Dentist | 1100 Wilford Hall Ambulatory Surgical Center, Lackland Afb, TX 78236 | 2016-08-04 |
| 1831544956 | Michael Veronneau | Student in an Organized Health Care Education/Training Program | 59 Mdw/ge 1100 Wilford Hall Loop, Bldg. 4554, Jbsa Lackland, TX 78236 | 2016-04-26 |
| 1376906958 | David Kephart Jr. | General Practice | 1100 Wilford Hall Loop Bldg 4454, Jbsa Lackland, TX 78236 | 2016-04-01 |
| 1184084089 | Olivia Arballo | Dermatology | Wilford Hall Asc, Attn: Dept of Dermatology, 1100 Wilford Hall Loop Bldg 4554, Jbsa-lackland, TX 78236 | 2016-03-04 |
| Find all providers in zip 78236 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679800734 | Dawn A Tanner | Social Worker | 1100 Wilford Hall Loop Bldg 455459, Jbsa Lackland, TX 78236 | 2009-11-11 |
| 1720175516 | Carol M Copeland | Social Worker | Wilford Hall Ambulatory Surg Center, 1100 Wilford Hall Loop, Jbsa Lackland, TX 78236 | 2006-10-05 |
| 1518443217 | Jessica Reynolds | Social Worker | 1100 Wilford Hall Loop Bldg 4554, Jbsa Lackland, TX 78236-5638 | 2018-07-16 |
| 1528571650 | Holly Johnson | Social Worker | 1100 Wilford Hall Loop, Bldg 4554, Attn: 59 Mdw/sghc, Jbsa Lackland, TX 78236 | 2017-11-11 |
| 1538527734 | Isaiah Jones | Social Worker | 1100 Wilford Hall Loop Bldg 4554, Jbsa Lackland, TX 78236-5638 | 2016-02-02 |
| 1861891046 | Chari Mcmahon | Social Worker | 1100 Wilford Hall Loop Bldg 4554, Jbsa Lackland, TX 78236-5638 | 2014-08-14 |
| 1861819690 | Mark Albulov | Social Worker | 1100 Wilford Hall Loop, Jbsa Lackland, TX 78236-5638 | 2014-03-18 |
| 1427492602 | Carol Louise Ameline | Social Worker | 1100 Wilford Hall Loop Bldg 4554, Jbsa Lackland, TX 78236 | 2013-04-18 |
| 1245593532 | Frances H. Martinez | Social Worker | 1100 Wilford Hall Loop, Jbsa Lackland, TX 78236-5638 | 2012-06-21 |
| 1407124100 | Barbara Beth Williams | Social Worker | 1100 Wilford Hall Loop Bldg 4554, Jbsa Lackland, TX 78236 | 2011-12-08 |
| Find all providers in JBSA LACKLAND | ||||
| City | JBSA LACKLAND |
| Zip Code | 78236 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.