Grant Edward Booth, MSW, LICSW, ACSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

10829 Issued in MN

Practice address

1499 Lincoln Ave
Saint Paul, MN 55105-2236

Phone

(651) 690-1542

Fax

(651) 690-1451

NPI assigned

Aug 2, 2005

Sex

Male

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

Opted out of Medicare

Previously, effective Aug 15, 2022 through Aug 15, 2026

Medicare enrollment (NPD)

Not enrolled

State licenses

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.

• Grant Booth PA Dba Booth Therapy

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Saint Paul, MN
  • NPI 1861915001
  NPD (past) Authorized official

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

{
    "created_epoch": "1122940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1972504728",
    "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",
            "fax_number": "651-690-1451"
        },
        {
            "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",
            "fax_number": "651-690-1451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOOTH",
        "first_name": "GRANT",
        "middle_name": "EDWARD",
        "credential": "MSW, LICSW, ACSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-02",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "10829",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bonnie Brae Psychotherapy LLC
• Roberta Lee Bonrud, RRT
• Elizabeth Bonson, M.D.
• Jenna Booher
• Irving Boone, PH.D
• Kathleen Marie Booth, RNC, NP
• Carrie M Borchardt, MD
• Troy Borchardt, LPCC
• Kathleen Mae Borchert, RN, CWOCN, ACNS-BC
• Liliana G Bordeianou, M.D.

• Clinical Social Worker in Saint Paul, MN
• Providers in Saint Paul, MN by specialty
• Clinical Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.