Grant Booth PA Dba Booth Therapy

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

GRANT BOOTH PA DBA BOOTH THERAPY

Practice address

1499 Lincoln Ave
Saint Paul, MN 55105-2236

Phone

(651) 690-1542

NPI assigned

Jul 19, 2017

Organization subpart

No

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

Authorized official

Name

Grant Edward Booth, MSW, LICSW, ACSWNPI 1972504728

Title

Therapist/Clinical Social Worker

Phone

(651) 690-1542

Specialties & licenses 1

Addresses

Practitioners 1

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

• Grant Edward Booth, MSW, LICSW, ACSW

  • Clinical Social Worker
  • Saint Paul, MN
  • NPI 1972504728
  NPD (past) Authorized official

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

{
    "created_epoch": "1500422400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1861915001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1499 LINCOLN AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551052236",
            "telephone_number": "651-690-1542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1499 LINCOLN AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551052236",
            "telephone_number": "651-690-1542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRANT BOOTH PA DBA BOOTH THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-19",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "BOOTH",
        "authorized_official_first_name": "GRANT",
        "authorized_official_middle_name": "EDWARD",
        "authorized_official_title_or_position": "THERAPIST/CLINICAL SOCIAL WORKER",
        "authorized_official_telephone_number": "651-690-1542",
        "authorized_official_credential": "MSW, LICSW, ACSW"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Grander Peace Counseling LLC
• Martha E Grandits, MD
• Tanya Marie Grangruth, ADC-T
• Jennifer Rose Granlund, P.T.
• Gregory Allen Granrud, M.D.
• McKenzie Grant, BSN, RN
• Melissa Aline Grant, PA-C
• Tiffany Marie Thayer Grant, LICSW
• Christianna Gratz Carlin, PT
• Thomas G Gratzer, MD

• Mental Health Clinic/Center (Including Community Mental Health Center) in Saint Paul, MN
• Providers in Saint Paul, MN by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.