MEDICARE: MS. RUTH ELLEN ATTEBURY LPC, CSAC

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	101YA0400X	Addiction (Substance Use Disorder) Counselor	0701003675	VA
2	101YM0800X	Mental Health Counselor	0701003675	VA

General Provider Information

NPI Number	:	1336234590
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. RUTH ELLEN ATTEBURY LPC, CSAC

Provider Business Mailing Address
First Line	:	11923 FALLEN HOLLY CT
Second Line	:
City	:	GREAT FALLS
State	:	VA
Zip	:	22066-1232
Country	:	US
Telephone Number	:	703-801-9705
Fax Number	:

Provider Business Practice Location Address
First Line	:	101 E HOLLY AVE
Second Line	:
City	:	STERLING
State	:	VA
Zip	:	20164-5402
Country	:	US
Telephone Number	:	703-801-9705
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/04/2006
Last Update Date	:	09/11/2025

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