Qol Behavioral Health LLC
Nurse Practitioner, Psych/Mental Health in Cibolo, TX. Organization (NPI-2).
NPI number1104719772
StatusActive
Last updated in NPPESJun 2, 2025
Details
- NPI
- 1104719772
- Entity type
- Organization (NPI-2)
- Legal business name
- Qol Behavioral Health LLC
- Organization subpart
- No
- Enumeration date
- Jun 2, 2025
- Certification date
- Jun 2, 2025
- Last updated
- Jun 2, 2025
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PART B SUPPLIER - CLINIC/GROUP PRACTICE
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LP0808X | Nurse Practitioner, Psych/Mental Health | – | – | Yes |
Practice location
105 Crimson TreeCibolo, TX 78108-4325
Phone 210-980-4767 · Fax 210-980-4664
Mailing address
105 Crimson TreeCibolo, TX 78108-4325
Phone 210-980-4767 · Fax 210-980-4664
Authorized official
Joshua M Novotny
Manager
2109804767
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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