Active NPI
Melody Ann Fortenberry, PH.D.
- Marriage & Family Therapist
- Dallas, TX
National Provider Identifier
1356417877
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 570
- Practice address
- 5757 Alpha Rd
Suite 209
Dallas, TX 75240-4601 - Phone
- (972) 458-9890
- Fax
- (972) 458-9890
- NPI assigned
- Nov 27, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 6
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 22645 | TX | |
| Clinical Psychologist | 103TC0700X | 22645 | TX | |
| Clinical Child & Adolescent Psychologist | 103TC2200X | 22645 | TX | |
| Family Psychologist | 103TF0000X | 22645 | TX | |
| Group Psychotherapy Psychologist | 103TP2701X | 22645 | TX | |
| Marriage & Family Therapist | 106H00000X | 570 | TX | Primary |
Addresses
Primary practice location
5757 Alpha Rd
Suite 209
Dallas, TX 75240-4601
Mailing address
5757 Alpha Rd
Suite 209
Dallas, TX 75240-4601
Phone (972) 458-9890
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00D39R | Other | TX | BLUE CROSS BLUE SHIELD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22645 | TX | MD | Clinical Psychologist |
| 570 | TX | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164585600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1757548800000",
"number": "1356417877",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5757 ALPHA RD",
"address_2": "SUITE 209",
"city": "DALLAS",
"state": "TX",
"postal_code": "752404601",
"telephone_number": "972-458-9890",
"fax_number": "972-458-9890"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5757 ALPHA RD",
"address_2": "SUITE 209",
"city": "DALLAS",
"state": "TX",
"postal_code": "752404601",
"telephone_number": "972-458-9890",
"fax_number": "972-458-9890"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FORTENBERRY",
"first_name": "MELODY",
"middle_name": "ANN",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-11-27",
"last_updated": "2025-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "TX",
"license": "22645",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "TX",
"license": "22645",
"primary": false
},
{
"code": "103TC2200X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical Child & Adolescent",
"state": "TX",
"license": "22645",
"primary": false
},
{
"code": "103TF0000X",
"taxonomy_group": "",
"desc": "Psychologist, Family",
"state": "TX",
"license": "22645",
"primary": false
},
{
"code": "103TP2701X",
"taxonomy_group": "",
"desc": "Psychologist, Group Psychotherapy",
"state": "TX",
"license": "22645",
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "TX",
"license": "570",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "00D39R",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.