Healthcare Provider Details

I. General information

NPI: 1306768924
Provider Name (Legal Business Name): SEAN CHRISTPHER SCRABA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2026
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 GRESHAM DR
NORFOLK VA
23507
US

IV. Provider business mailing address

1000 BROOKSIDE CT
CHESAPEAKE VA
23322-9523
US

V. Phone/Fax

Practice location:
  • Phone: 757-668-4747
  • Fax: 757-668-7664
Mailing address:
  • Phone: 757-773-2885
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number0904020549
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: