Organization
CLARK COMMUNITY MENTAL HEALTH CENTER
Active
Organization
CLARK COMMUNITY MENTAL HEALTH CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANGELA SUPPLEE (PAYER ENROLLMENT MANAGER)
(417) 476-1000
Entity
Organization
Contact information
Practice address
1701 N CENTRAL AVE, MONETT, MO 65708-9999
(417) 476-1000
(471) 476-1082
Mailing address
PO BOX 100, 104 W MAIN ST, PIERCE CITY, MO 65723-2100
(417) 476-1000
(417) 943-5693
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
2470-8563
MO
103TC1900X
Counseling Psychologist
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
560197402
—
MO
Enumeration date
08/10/2006
Last updated
07/23/2026
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