Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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MS. Kimberley B Green, MS, CCC-SLP

Individual provider Speech-Language Pathologist · NPI 1235448119

MS. Kimberley B Green, MS, CCC-SLP is a Qualified Speech Language Pathologist in Suffolk, Virginia. Qualified in 2021, 5 years ago. Practices with Legacy Healthcare Services Inc, a 3,624-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in Virginia.

Years since qualifying
5
Licensed in
VA
In the registry since
2010
What do these letters mean?
MS — Master of Science
A graduate science degree.
CCC-SLP — Certificate of Clinical Competence in Speech-Language Pathology
A speech-language pathologist certified by ASHA.

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Practice location Address checks out

100 N Main St
Suffolk, VA 23434
Phone: (757) 925-6764
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 4016 Raintree Rd, Chesapeake, VA 23321-3700 — (757) 488-2864
  • 100 N Main St, Suffolk, VA 23434 — (757) 925-6764

Specialties & licences

Speech-Language Pathologist (primary) Taxonomy 235Z00000X · Licence 2202003947 (VA)

Record details

NPI number1235448119
Entity typeIndividual (Type 1)
GenderFemale
Credentials MS , CCC-SLP
Sole proprietorNo
NPI enumeratedSeptember 27, 2010
Last updated in NPPESSeptember 17, 2019

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyQUALIFIED SPEECH LANGUAGE PATHOLOGIST
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Legacy Healthcare Services Inc — 3624 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations5 on file with Medicare

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