MEDICARE: URBAN THERAPY CLINICAL DEPARTMENT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1952251548
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	URBAN THERAPY CLINICAL DEPARTMENT

Provider Business Mailing Address
First Line	:	1408 N KINGSHIGHWAY BLVD STE 108
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63113-1418
Country	:	US
Telephone Number	:	314-615-3600
Fax Number	:

Provider Business Practice Location Address
First Line	:	929 N SPRING AVE
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63108-3629
Country	:	US
Telephone Number	:	314-615-3600
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR OF CLINICAL SERVICES
Name	:	JOY CAMP
Credential	:	MA, LPC
Telephone Number	:	314-615-3600

Provider Enumeration Date	:	02/02/2026
Last Update Date	:	02/02/2026

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