Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

PROVISIONS2LIVE BEHAVIORAL HEALTH PLLC
NPI 1073255055
Clinical Nurse Specialist - Psychiatric/Mental Health in Durham, NC

Q: What is Provisions2live Behavioral Health PLLC's specialty?

The primary specialty registered for this NPI is Clinical Nurse Specialist, specializing in Psychiatric/Mental Health, with taxonomy code 364SP0808X.

Active since April 11, 2022

3622 LYCKAN PKWY STE 4006, DURHAM, NC 27707(919) 390-1398(919) 910-5668 Get Directions Write a Review

NPPES record last updated: July 20, 2026. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jul 20, 2026, Jul 19, 2026, Jul 9, 2026 and 5 more (8 updates tracked since 2022).

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About Provisions2live Behavioral Health Pllc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PROVISIONS2LIVE BEHAVIORAL HEALTH PLLC (NPI 1073255055) is a healthcare organization registered as a psychiatric/mental health in Durham, North Carolina and active in the NPI registry since April 2022. The organization lists Jennifer Inez Mclean-russ, Pmh-np, as its authorized official.

NPPES Registry Identity

NPI1073255055

Entity TypeOrganization

Primary Taxonomy364SP0808X

Legal Business NamePROVISIONS2LIVE BEHAVIORAL HEALTH PLLC

Location Address3622 LYCKAN PKWY STE 4006Durham, NC 27707-2566

Mailing Address3622 Lyckan Pkwy Ste 4006Durham, NC 27707-2566 · (919) 390-1398 · Fax (919) 910-5668

Phone(919) 390-1398

Fax(919) 910-5668

Organization SubpartNo

Authorized OfficialJennifer Inez Mclean-russPmh-np · (919) 390-1398

Enumeration DateApril 11, 2022

Last NPPES UpdateJuly 20, 20268 updates tracked since enumeration

NPPES CertifiedJuly 20, 2026

✔ NPI 1073255055 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinical Nurse Specialist · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code364SP0808X

3622 LYCKAN PKWY STE 4006, Durham, NC 27707

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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. JENNIFER INEZ MCLEAN-RUSS PMHNP-BC

Clinical Nurse Specialist (Psychiatric/Mental Health)

3622 LYCKAN PKWY STE 4006
DURHAM, NC 27707

Durham County (919) 390-1398

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Provisions2live Behavioral Health PLLC's NPI number?

The NPI number for Provisions2live Behavioral Health PLLC is 1073255055. It was assigned to this organization in the NPPES registry on April 11, 2022.

Where is Provisions2live Behavioral Health PLLC located?

Provisions2live Behavioral Health PLLC is located at 3622 Lyckan Pkwy Ste 4006, Durham, NC 27707. The listed phone number is (919) 390-1398.

What is Provisions2live Behavioral Health PLLC's specialty?

The primary specialty registered for this NPI is Clinical Nurse Specialist, specializing in Psychiatric/Mental Health, with taxonomy code 364SP0808X.

When was this NPI record last updated?

The NPPES record for Provisions2live Behavioral Health PLLC was last updated on July 20, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 30 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.