Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Tideline Psych PLLC

Organization Physician Assistant · NPI 1578384301

Tideline Psych PLLC is a Physician Assistant in Wilmington, North Carolina. Registered with an NPI since 2024.

In the registry since
2024
Specialties on file
3
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

226 N Frnt ST # 129
Wilmington, NC 28401-3920
Phone: (910) 469-4690
Fax: (910) 933-7084
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X
Medical Physician Assistant Taxonomy 363AM0700X
Psychiatric/Mental Health Nurse Practitioner Taxonomy 363LP0808X

Record details

NPI number1578384301
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official William Bunting — Practice Manager · (252) 341-3320
NPI enumeratedOctober 23, 2024
Last updated in NPPESJune 5, 2026
Certification dateJune 5, 2026
Mailing address226 N Front St # 129, Wilmington, NC 28401-3920

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