MEDICARE: ANCESTRAL TREE WELLNESS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1417880212
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ANCESTRAL TREE WELLNESS

Provider Business Mailing Address
First Line	:	5662 SCOTTY CT
Second Line	:
City	:	HILLIARD
State	:	OH
Zip	:	43026-9626
Country	:	US
Telephone Number	:	614-345-8933
Fax Number	:

Provider Business Practice Location Address
First Line	:	5662 SCOTTY CT
Second Line	:
City	:	HILLIARD
State	:	OH
Zip	:	43026-9626
Country	:	US
Telephone Number	:	614-345-8933
Fax Number	:

Authorized Official
Title or Position	:	LICENSED INDEPENDENT SOCIAL WORKER
Name	:	MECA S SEWARD
Credential	:	LISW
Telephone Number	:	614-345-8933

Provider Enumeration Date	:	06/03/2026
Last Update Date	:	06/03/2026

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Directions to “ANCESTRAL TREE WELLNESS ” Practice Location

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