# TIDELINE PSYCH PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1578384301
- **Authorized official:** MR. WILLIAM THOMAS BUNTING JR. (PRACTICE MANAGER)
- **Authorized official phone:** (252) 341-3320

## Contact information

- **Practice address:** 226 N FRONT ST \# 129, WILMINGTON, NC 28401-3920
- **Practice address phone:** (910) 469-4690
- **Practice address fax:** (910) 933-7084
- **Mailing address:** 226 N FRONT ST \# 129, WILMINGTON, NC 28401-3920
- **Mailing address phone:** (910) 469-4690
- **Mailing address fax:** (910) 933-7084

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363A00000X | Physician Assistant | — | — | Yes |
| 363AM0700X | Medical Physician Assistant | — | — | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 10/23/2024
- **Last updated:** 06/05/2026