| Light Space Mental Health Counseling Pllc | |
|
418 Broadway Ste 4279 Albany NY 12207-2922 | |
| (937) 756-6697 | |
| Not Available |
| Full Name | Light Space Mental Health Counseling Pllc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 418 Broadway Ste 4279, Albany, New York |
| Authorized Official Name and Position | Joey Bukai (OWNER) |
| Authorized Official Contact | 9377566697 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Light Space Mental Health Counseling Pllc 418 Broadway Ste 4279 Albany NY 12207-2922 Ph: (937) 756-6697 | Light Space Mental Health Counseling Pllc 418 Broadway Ste 4279 Albany NY 12207-2922 Ph: (937) 756-6697 |
| NPI Number | 1467149856 |
|---|---|
| Provider Enumeration Date | 04/18/2023 |
| Last Update Date | 04/18/2023 |
| Certification Date | 04/18/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467149856 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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