Provider Demographics
NPI:1477253250
Name:DECARLO, AIMEE MARIE (PEER SUPPORTER)
Entity Type:Individual
Prefix:
First Name:AIMEE
Middle Name:MARIE
Last Name:DECARLO
Suffix:
Gender:F
Credentials:PEER SUPPORTER
Other - Prefix:
Other - First Name:AIMEE
Other - Middle Name:MARIE
Other - Last Name:JANUS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1705 WOODLAND ST NE
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:OH
Mailing Address - Zip Code:44483-5348
Mailing Address - Country:US
Mailing Address - Phone:330-469-6777
Mailing Address - Fax:
Practice Address - Street 1:THRIVE COUNSELING
Practice Address - Street 2:1705 WOODLAND ST. NE
Practice Address - City:WARREN
Practice Address - State:OH
Practice Address - Zip Code:44483-5348
Practice Address - Country:US
Practice Address - Phone:330-469-6777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-09
Last Update Date:2023-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPS.003407175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist