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Organization
LIGHT SPACE MENTAL HEALTH COUNSELING AND NURSE PRACTITIONER IN PSYCHIATRY PLLC
Active
Organization
LIGHT SPACE MENTAL HEALTH COUNSELING AND NURSE PRACTITIONER IN PSYCHIATRY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOEY BUKAI PMHNP-BC, LMHC, RN (OWNER)
(937) 756-6697
Entity
Organization
Contact information
Practice address
418 BROADWAY STE 4279, ALBANY, NY 12207-2922
(937) 756-6697
Mailing address
418 BROADWAY STE 4279, ALBANY, NY 12207-2922
(937) 756-6697
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
NULL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
04/18/2023
Last updated
08/15/2025
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