Provider Demographics
NPI:1396289427
Name:TIDE ASSOCIATES PLLC
Entity type:Organization
Organization Name:TIDE ASSOCIATES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:W
Authorized Official - Last Name:SWINSON
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LCSW
Authorized Official - Phone:910-939-8433
Mailing Address - Street 1:249 PALM GROVE DRIVE
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28411
Mailing Address - Country:US
Mailing Address - Phone:910-939-8433
Mailing Address - Fax:866-728-0006
Practice Address - Street 1:3205 RANDALL PARKWAY
Practice Address - Street 2:SUITE 128
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403
Practice Address - Country:US
Practice Address - Phone:910-939-8433
Practice Address - Fax:866-728-0006
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-08
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty