Individual provider Active NPI

Taniesh Amon, PSYD

  • Clinical Psychologist
  • Anchorage, AK
National Provider Identifier
1396490405
Registry record updated Jul 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
184612 Issued in AK
Practice address
4441 Diplomacy Dr
Anchorage, AK 99508-5910
Phone
(907) 729-8880
NPI assigned
Feb 16, 2022
Last updated
Jul 25, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X 184612 AK
Clinical Psychologist 103TC0700X 184612 AK Primary
Clinical Child & Adolescent Psychologist 103TC2200X 184612 AK

Addresses

Primary practice location

4441 Diplomacy Dr
Anchorage, AK 99508-5910

Mailing address

7033 E Tudor Rd
Anchorage, AK 99507-1262
Phone (907) 729-3300

Other names 1

  • Taniesh Lue Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250708004526 TX Practitioner - Clinical Psychologist 8022522457 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
184612AKMDClinical Child & Adolescent Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Alaska Native Tribal Health Consortium CurrentSince Apr 5, 2025 Accepting new patients
Southcentral Foundation CurrentSince Apr 5, 2025 Accepting new patients
Southcentral Foundation Current Accepting new patients
Southcentral Foundation Clinical CurrentSince Apr 5, 2025 Accepting new patients

Locations

400 W Benson Blvd
Anchorage, AK 99503
Phone (907) 729-4654

4315 Diplomacy Dr
Anchorage, AK 99508
Phone (907) 729-1729

4320 Diplomacy Dr
Anchorage, AK 99508
Phone (907) 729-0000

4441 Diplomacy Dr
Anchorage, AK 99508
Phone (907) 729-2000

7033 E Tudor Rd
Anchorage, AK 99507
Phone (907) 729-0000

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1644969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753401600000",
    "number": "1396490405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7033 E TUDOR RD",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995071262",
            "telephone_number": "907-729-3300",
            "fax_number": "907-729-5180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4441 DIPLOMACY DR",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995085910",
            "telephone_number": "907-729-8880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMON",
        "first_name": "TANIESH",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-16",
        "last_updated": "2025-07-25",
        "certification_date": "2025-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "AK",
            "license": "184612",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "AK",
            "license": "184612",
            "primary": true
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "AK",
            "license": "184612",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TANIESH",
            "last_name": "LUE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Anchorage, AK

Sources for this page

Verify at the official NPI Registry.