Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Dr. Tyler Maxwell Dority, PHD, LP

Individual provider Counseling Psychologist · NPI 1104394212

Dr. Tyler Maxwell Dority, PHD, LP is a Clinical Psychologist in Mankato, Minnesota. Qualified in 2016, 10 years ago. Practices as a sole proprietor, works from 3 locations, accepts Medicare assignment and offers telehealth. Licensed in Minnesota.

Years since qualifying
10
Licensed in
MN
In the registry since
2018
Specialties on file
3
What do these letters mean?
PHD — Doctor of Philosophy
A research doctorate. In healthcare it usually sits alongside a clinical licence.

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Practice location Address checks out

12 Civic Center Plz Ste 1615
Mankato, MN 56001-7783
Phone: (507) 345-4679
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 32298 State Highway 13, Montgomery, MN 56069-4348 — (507) 364-5312
  • 922 Swift St, Saint Peter, MN 56082-1844 — (507) 364-5312

Specialties & licences

Clinical Psychologist (primary) Taxonomy 103TC0700X · Licence LP6328 (MN)
Counseling Psychologist Taxonomy 103TC1900X · Licence LP6328 (MN)
Forensic Psychologist Taxonomy 103TF0200X · Licence LP6328 (MN)

Record details

NPI number1104394212
Entity typeIndividual (Type 1)
GenderMale
Credentials PHD , LP
Sole proprietorYes
NPI enumeratedNovember 6, 2018
Last updated in NPPESAugust 2, 2022
Certification dateAugust 2, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL PSYCHOLOGIST
Medical schoolOTHER
Graduated 2016 (10 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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