Active NPI
Jadon Daniel Stino Gibson, LMHC
- Mental Health Counselor
- Riverview, FL
National Provider Identifier
1639876022
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 25056
- Practice address
- 12923 Jessup Watch PL
Riverview, FL 33579-4065 - Phone
- (813) 817-8195
- NPI assigned
- Feb 15, 2023
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 25056 | FL | Primary |
Addresses
Primary practice location
12923 Jessup Watch PL
Riverview, FL 33579-4065
Mailing address
12923 Jessup Watch PL
Riverview, FL 33579-4065
Phone (813) 817-8195
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25056 | FL | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1676419200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1754524800000",
"number": "1639876022",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12923 JESSUP WATCH PL",
"city": "RIVERVIEW",
"state": "FL",
"postal_code": "335794065",
"telephone_number": "813-817-8195"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12923 JESSUP WATCH PL",
"city": "RIVERVIEW",
"state": "FL",
"postal_code": "335794065",
"telephone_number": "813-817-8195"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GIBSON",
"first_name": "JADON",
"middle_name": "DANIEL STINO",
"credential": "LMHC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-02-15",
"last_updated": "2025-08-07",
"certification_date": "2025-08-07",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "FL",
"license": "25056",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Riverview, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 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.