Provider Demographics
NPI:1124838008
Name:HAVLIN, LAUREN RENEE (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:RENEE
Last Name:HAVLIN
Suffix:
Gender:
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 BELMONT PL SE UNIT 3216
Mailing Address - Street 2:
Mailing Address - City:SMYRNA
Mailing Address - State:GA
Mailing Address - Zip Code:30080-1988
Mailing Address - Country:US
Mailing Address - Phone:630-687-0276
Mailing Address - Fax:
Practice Address - Street 1:2635 CENTURY PKWY NE STE 250
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30345-3166
Practice Address - Country:US
Practice Address - Phone:770-927-7424
Practice Address - Fax:404-480-0784
Is Sole Proprietor?:No
Enumeration Date:2025-01-13
Last Update Date:2025-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASLP013416235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist