Individual provider Active NPI

Diana J Depugh, MSW

  • Addiction (Substance Use Disorder) Counselor
  • Knoxville, TN
National Provider Identifier
1619954609
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
LDC00000086 Issued in TN
Practice address
4928 Homberg Dr
Suie 4-a
Knoxville, TN 37919-5100
Phone
(865) 748-4476
NPI assigned
Dec 29, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X LDC00000086 TN Primary
Clinical Social Worker 1041C0700X LSW0000003551 TN

Addresses

Primary practice location

4928 Homberg Dr
Suie 4-a
Knoxville, TN 37919-5100

Mailing address

3110 Pleasant Trace Cir
Knoxville, TN 37912-6207
Phone (865) 748-4476

Other identifiers 1

IdentifierTypeStateIssuer
1100250OtherTNCIGNA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20061013000174 TN Practitioner - Clinical Social Worker 2668478702 Practice locations: Powder Springs, TN

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

2532 Round Barn Rd
Powder Springs, TN 37848-2418
Phone (865) 748-4476

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LDC00000086TNMDAddiction (Substance Use Disorder) Counselor
LSW0000003551TNMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1135814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1619954609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3110 PLEASANT TRACE CIR",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379126207",
            "telephone_number": "865-748-4476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4928 HOMBERG DR",
            "address_2": "SUIE 4-A",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379195100",
            "telephone_number": "865-748-4476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEPUGH",
        "first_name": "DIANA",
        "middle_name": "J",
        "name_prefix": "Ms.",
        "credential": "MSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-12-29",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "TN",
            "license": "LDC00000086",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TN",
            "license": "LSW0000003551",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "1100250",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Knoxville, TN

Sources for this page

Verify at the official NPI Registry.