Jordan Southern

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Practice address

1616 S Gold St Ste 4
Centralia, WA 98531-8930

Phone

(360) 261-6930

NPI assigned

Aug 18, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Community Integrated Health Services, LLC

  • Community/Behavioral Health Agency
  • Centralia, WA
  • NPI 1942840160

  Mental Health

  NPD (past)
• Core Health

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Longview, WA
  • NPI 1639693781
  NPD (past)

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

{
    "created_epoch": "1660780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782259200000",
    "number": "1558089300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1902 AHLERS AVE APT 2",
            "city": "CENTRALIA",
            "state": "WA",
            "postal_code": "985313479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1616 S GOLD ST STE 4",
            "city": "CENTRALIA",
            "state": "WA",
            "postal_code": "985318930",
            "telephone_number": "360-261-6930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOUTHERN",
        "first_name": "JORDAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-18",
        "last_updated": "2026-06-24",
        "certification_date": "2026-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• South Creek SNF Healthcare LLC
• South Puget Sound ABA LLC
• South Sound Inpatient Physicians PLLC
• South Sound Oral Surgery PLLC
• South Sound Radiology - Lewis County
• Southwest Washington Anesthesia PS
• Southwest Washington Diagnostics LP
• Michael Spain
• Sarah C Spencer, ARNP
• Jill Delores Spyhalski, AAC

• Clinical Social Worker in Centralia, WA
• Providers in Centralia, WA by specialty
• Clinical Social Worker in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 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.