Individual provider Active NPI

Lauren Jo Havens, MSN, FNP

  • Addiction Medicine (Family Medicine) Physician
  • Fayetteville, NY
National Provider Identifier
1235279407
Registry record updated Aug 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction Medicine (Family Medicine) PhysicianTaxonomy code 207QA0401X
License
334767 Issued in NY
Practice address
519 E Genesee St
Fayetteville, NY 13066-1536
Phone
(315) 968-2733
Fax
(315) 305-5029
NPI assigned
Feb 7, 2007
Last updated
Aug 1, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 1, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction Medicine (Family Medicine) Physician 207QA0401X 334767 NY Primary

Addresses

Primary practice location

519 E Genesee St
Fayetteville, NY 13066-1536

Mailing address

4605 Pewter LN
Manlius, NY 13104-9329
Phone (315) 968-2733

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science - Nursing

State licenses

LicenseStateTypeSpecialty
334767NYMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Cny Facial Surgery Group, PC PastSince Jul 8, 2014 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785542400000",
    "number": "1235279407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4605 PEWTER LN",
            "city": "MANLIUS",
            "state": "NY",
            "postal_code": "131049329",
            "telephone_number": "315-968-2733",
            "fax_number": "315-305-5029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "519 E GENESEE ST",
            "city": "FAYETTEVILLE",
            "state": "NY",
            "postal_code": "130661536",
            "telephone_number": "315-968-2733",
            "fax_number": "315-305-5029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAVENS",
        "first_name": "LAUREN",
        "middle_name": "JO",
        "name_prefix": "Miss",
        "credential": "MSN, FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-07",
        "last_updated": "2026-08-01",
        "certification_date": "2026-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0401X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Addiction Medicine",
            "state": "NY",
            "license": "334767",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2026; 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.