My Self Wellness Ins LLC

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

Legal business name

MY SELF WELLNESS INS LLC

Practice address

3541 Bonita Bay Blvd Ste 100
Bonita Springs, FL 34134-1703

Phone

(239) 908-9958

Fax

(239) 319-5729

NPI assigned

Jan 5, 2026

Organization subpart

No

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

Authorized official

Name

Jessica Seibert

Title

Office Manager

Phone

(239) 908-9958

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1767571200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1767916800000",
    "number": "1861358764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3541 BONITA BAY BLVD STE 100",
            "city": "BONITA SPRINGS",
            "state": "FL",
            "postal_code": "341341703",
            "telephone_number": "239-908-9958",
            "fax_number": "239-319-5729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3541 BONITA BAY BLVD STE 100",
            "city": "BONITA SPRINGS",
            "state": "FL",
            "postal_code": "341341703",
            "telephone_number": "239-908-9958",
            "fax_number": "239-319-5729"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MY SELF WELLNESS INS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-01-05",
        "last_updated": "2026-01-09",
        "certification_date": "2026-01-09",
        "status": "A",
        "authorized_official_last_name": "SEIBERT",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "239-908-9958"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2026; 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.