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
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1699309302
—
NY
01
—
407127
NY PMHNP STATE LICENSE
NY
Enumeration date
04/18/2023
Last updated
08/15/2025
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