MEDICARE: DONALD JOSEPH GIECK PH.D.

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	103TC0700X	Clinical Psychologist	0810004009	VA
2	103T00000X	Psychologist	0810004009	VA

General Provider Information

NPI Number	:	1861518037
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DONALD JOSEPH GIECK PH.D.

Provider Business Mailing Address
First Line	:	213 S JEFFERSON ST STE 1006
Second Line	:
City	:	ROANOKE
State	:	VA
Zip	:	24011-1713
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4434 ELECTRIC RD
Second Line	:
City	:	ROANOKE
State	:	VA
Zip	:	24018-0722
Country	:	US
Telephone Number	:	540-527-4900
Fax Number	:

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

Provider Enumeration Date	:	03/21/2007
Last Update Date	:	08/15/2025

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