NPIMap

Organization Active NPI

Clark Community Mental Health Center

  • Community/Behavioral Health Agency
  • Monett, MO
National Provider Identifier
1801807771
Registry record updated Jul 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
CLARK COMMUNITY MENTAL HEALTH CENTER
Practice address
1701 N Central Ave
Monett, MO 65708-9999
Phone
(417) 476-1000
Fax
(471) 476-1082
NPI assigned
Aug 10, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2026

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

Authorized official

Name
Angela Supplee
Title
Payer Enrollment Manager
Phone
(417) 476-1000

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X 2470-8563 MO
Counseling PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC1900X
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

1701 N Central Ave
Monett, MO 65708-9999

Mailing address

PO Box 100
104 W Main St
Pierce City, MO 65723-2100
Phone (417) 476-1000

Other practice location 1

123 N Wetzel St
Greenfield, MO 65661-8208
Phone (417) 476-1000

Other practice location 2

1701 Townsend St
Cassville, MO 65625-1451
Phone (417) 476-1000

Other practice location 3

1810 S Carnation Dr
Aurora, MO 65605-2162
Phone (417) 476-1000

Other practice location 4

25832 State Highway Yy
Shell Knob, MO 65747-7420
Phone (417) 476-1000

Other practice location 5

1001 E Daniel Dr
Mount Vernon, MO 65712-9690
Phone (417) 476-1000

Other practice location 6

411 3rd St
Monett, MO 65708-2008
Phone (417) 476-1000

Other identifiers 1

IdentifierTypeStateIssuer
560197402MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070123000267 MO Part B Supplier - Clinic/Group Practice 8527069277 Receives reassigned benefits from 42 practitioners
Practice locations: Mount Vernon, MO; Shell Knob, MO; Pierce City, MO; Monett, MO; Greenfield, MO; Cassville, MO; Aurora, MO

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
26D2331891Clark Community Mental Health Center411 3Rd Street, Monett, MO 65708Certificate of waiverOct 8, 2027
26D2331901Clark Community Mental Health Center123 N Wetzel St, Greenfield, MO 65661Certificate of waiverOct 8, 2027
26D2331903Clark Community Mental Health Center1701 Townsend, Cassville, MO 65625Certificate of waiverOct 8, 2027
26D2331905Clark Community Mental Health Center1810 S Carnation Dr, Aurora, MO 65605Certificate of waiverOct 8, 2027

National Provider Directory

National Provider Directory
Tax ID family
Clark Community Mentalhealth Center13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1701 Townsend St
Cassville, MO 65625
Phone (417) 671-8075

802 State Highway 248
Ste 5
Cassville, MO 65625
Phone (417) 846-1935

404 State Highway 248
Ste 5
Cassville, MO 65625
Phone (417) 461-0580

406 College St
Greenfield, MO 65661
Phone 4174761000212

123 N Wetzel St
Greenfield, MO 65661
Phone (417) 637-0129

1001 E Daniel Dr
Mount Vernon, MO 65712

997 E Daniel Dr
Mount Vernon, MO 65712

Practitioners & affiliated clinicians

Practitioners 60

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 60

NPI Registry JSON

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

{
    "created_epoch": "1155168000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1784764800000",
    "number": "1801807771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 100",
            "address_2": "104 W MAIN ST",
            "city": "PIERCE CITY",
            "state": "MO",
            "postal_code": "657232100",
            "telephone_number": "417-476-1000",
            "fax_number": "417-943-5693"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 N CENTRAL AVE",
            "city": "MONETT",
            "state": "MO",
            "postal_code": "657089999",
            "telephone_number": "417-476-1000",
            "fax_number": "471-476-1082"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "123 N Wetzel St",
            "address_purpose": "LOCATION",
            "city": "Greenfield",
            "state": "MO",
            "postal_code": "656618208",
            "country_code": "US",
            "telephone_number": "417-476-1000",
            "fax_number": "417-943-5693",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1701 Townsend St",
            "address_purpose": "LOCATION",
            "city": "Cassville",
            "state": "MO",
            "postal_code": "656251451",
            "country_code": "US",
            "telephone_number": "417-476-1000",
            "fax_number": "417-943-5693",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1810 S Carnation Dr",
            "address_purpose": "LOCATION",
            "city": "Aurora",
            "state": "MO",
            "postal_code": "656052162",
            "country_code": "US",
            "telephone_number": "417-476-1000",
            "fax_number": "417-943-5693",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "25832 State Highway Yy",
            "address_purpose": "LOCATION",
            "city": "Shell Knob",
            "state": "MO",
            "postal_code": "657477420",
            "country_code": "US",
            "telephone_number": "417-476-1000",
            "fax_number": "417-943-5693",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1001 E Daniel Dr",
            "address_purpose": "LOCATION",
            "city": "Mount Vernon",
            "state": "MO",
            "postal_code": "657129690",
            "country_code": "US",
            "telephone_number": "417-476-1000",
            "fax_number": "417-943-5693",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "411 3rd St",
            "address_purpose": "LOCATION",
            "city": "Monett",
            "state": "MO",
            "postal_code": "657082008",
            "country_code": "US",
            "telephone_number": "417-476-1000",
            "fax_number": "417-943-5693",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CLARK COMMUNITY MENTAL HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-10",
        "last_updated": "2026-07-23",
        "certification_date": "2026-07-23",
        "status": "A",
        "authorized_official_last_name": "SUPPLEE",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_title_or_position": "PAYER ENROLLMENT MANAGER",
        "authorized_official_telephone_number": "417-476-1000"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "MO",
            "license": "2470-8563",
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Counseling",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "560197402",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Monett, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.