Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Jill Marie Ingersoll, LCSW

Individual provider Clinical Social Worker · NPI 1912760901

Jill Marie Ingersoll, LCSW is a Clinical Social Worker in Canyon Lake, Texas. Qualified in 2019, 7 years ago. Practices with S Kincheloe Counseling PLLC, a 3-clinician group and accepts Medicare assignment. Licensed in Texas.

Years since qualifying
7
Licensed in
TX
In the registry since
2024
What do these letters mean?
LCSW — Licensed Clinical Social Worker
A social worker licensed to diagnose and treat mental health conditions independently.

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Practice location Address checks out

1010 Blue Water Dr
Canyon Lake, TX 78133-5584
Phone: (180) 848-9543
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 67137 (TX)

Record details

NPI number1912760901
Entity typeIndividual (Type 1)
GenderFemale
Credentials LCSW
Sole proprietorYes
NPI enumeratedFebruary 1, 2024
Last updated in NPPESFebruary 1, 2024
Certification dateFebruary 1, 2024

Medicare enrollment

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

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice S Kincheloe Counseling Pllc — 3 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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