Provider Demographics
NPI:1265152706
Name:BRODAR, KAITLYN ELYSE BATT (PHD)
Entity type:Individual
Prefix:DR
First Name:KAITLYN
Middle Name:ELYSE BATT
Last Name:BRODAR
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27292-2840
Mailing Address - Country:US
Mailing Address - Phone:202-810-4552
Mailing Address - Fax:
Practice Address - Street 1:1400 S MAIN ST
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:NC
Practice Address - Zip Code:27292-2840
Practice Address - Country:US
Practice Address - Phone:202-810-4552
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-02
Last Update Date:2025-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810008449103TC0700X
MD06841103TC0700X
DCPSYA200001284103TC0700X
NC6486103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical