Active NPI
Alex Holdaway, PHD
- Clinical Child & Adolescent Psychologist
- Philadelphia, PA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Child & Adolescent Psychologist
- License
- PS019029
- Practice address
- 3401 Civic Center Blvd
Philadelphia, PA 19104-4319 - Phone
- (267) 425-9675
- NPI assigned
- Sep 17, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Child & Adolescent Psychologist | 103TC2200X | 0810008966 | VA | |
| Clinical Child & Adolescent Psychologist | 103TC2200X | PS019029 | PA | Primary |
Addresses
Primary practice location
3401 Civic Center Blvd
Philadelphia, PA 19104-4319
Mailing address
PO Box 780125
Philadelphia, PA 19178-0125
Phone (804) 922-4844
Other practice location 1
1308 Sherwood Ave
Richmond, VA 23220-1210
Phone (804) 828-8200
Other practice location 2
1250 E Marshall St
Richmond, VA 23298-5023
Phone (804) 828-8200
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in VA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 2017
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
PO Box
Philadelphia, PA 19178
PO Box
Suite 980503
Richmond, VA 23298
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PS019029 | PA | MD | Clinical Child & Adolescent Psychologist |
| 0810008966 | VA | MD | Clinical Child & Adolescent Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| MCV Associated Physicians | Current | Accepting new patients |
Locations
1250 E Marshall St
Richmond, VA 23298
Phone (804) 628-6990
1308 Sherwood Ave
Richmond, VA 23220
Phone (804) 828-3129
401 N 11th St
Richmond, VA 23219
Phone (804) 828-4409
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1631836800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1767744000000",
"number": "1710657069",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 780125",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191780125",
"telephone_number": "804-922-4844"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3401 CIVIC CENTER BLVD",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191044319",
"telephone_number": "267-425-9675"
}
],
"practiceLocations": [
{
"address_1": "1308 Sherwood Ave",
"address_purpose": "LOCATION",
"city": "Richmond",
"state": "VA",
"postal_code": "232201210",
"country_code": "US",
"telephone_number": "804-828-8200",
"fax_number": "804-628-3279",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1250 E Marshall St",
"address_purpose": "LOCATION",
"city": "Richmond",
"state": "VA",
"postal_code": "232985023",
"country_code": "US",
"telephone_number": "804-828-8200",
"fax_number": "804-628-3279",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "HOLDAWAY",
"first_name": "ALEX",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-09-17",
"last_updated": "2026-01-07",
"certification_date": "2026-01-07",
"status": "A"
},
"taxonomies": [
{
"code": "103TC2200X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical Child & Adolescent",
"state": "VA",
"license": "0810008966",
"primary": false
},
{
"code": "103TC2200X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical Child & Adolescent",
"state": "PA",
"license": "PS019029",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.