Healthcare Provider Details

I. General information

NPI: 1992660633
Provider Name (Legal Business Name): TOGETHER THERAPY LCSW PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/16/2025
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3522 JAMES ST
SYRACUSE NY
13206-2485
US

IV. Provider business mailing address

4983 S EAGLE VILLAGE RD
MANLIUS NY
13104-9459
US

V. Phone/Fax

Practice location:
  • Phone: 315-316-4368
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: ALEXANDER PORTILLO
Title or Position: CO-OWNER
Credential: LCSW
Phone: 315-316-4368