Provider Demographics
NPI:1730652603
Name:ELIZABETH Y. SKJOLDAL PH.D., LLC
Entity Type:Organization
Organization Name:ELIZABETH Y. SKJOLDAL PH.D., LLC
Other - Org Name:THE JOURNEY TO WELLNESS CARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:YOLANDA
Authorized Official - Last Name:SKJOLDAL
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:305-588-2464
Mailing Address - Street 1:8325 NE 2ND AVE STE 316
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33138-3815
Mailing Address - Country:US
Mailing Address - Phone:305-588-2464
Mailing Address - Fax:305-851-3136
Practice Address - Street 1:8325 NE 2ND AVE STE 316
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33138-3815
Practice Address - Country:US
Practice Address - Phone:305-503-5758
Practice Address - Fax:305-851-3136
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-03
Last Update Date:2022-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Single Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL013881305Medicaid
FL59431OtherFLORIDA BLUE
FLP3N90K50NOtherOPTUM
FL273086000OtherMAGELLAN
FL9367379OtherAETNA