Provider Demographics
NPI:1639889629
Name:BREWER, MAKAYLA (LICSW)
Entity type:Individual
Prefix:
First Name:MAKAYLA
Middle Name:
Last Name:BREWER
Suffix:
Gender:
Credentials:LICSW
Other - Prefix:
Other - First Name:MAKAYLA
Other - Middle Name:
Other - Last Name:LOLLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW
Mailing Address - Street 1:12701 PADGETT SWITCH RD
Mailing Address - Street 2:
Mailing Address - City:IRVINGTON
Mailing Address - State:AL
Mailing Address - Zip Code:36544-4011
Mailing Address - Country:US
Mailing Address - Phone:251-824-2174
Mailing Address - Fax:
Practice Address - Street 1:12701 PADGETT SWITCH RD
Practice Address - Street 2:
Practice Address - City:IRVINGTON
Practice Address - State:AL
Practice Address - Zip Code:36544-4011
Practice Address - Country:US
Practice Address - Phone:251-824-2174
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-30
Last Update Date:2025-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL6203C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical