# MHC CHILD PROTECTION

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

## Provider details

- **NPI number:** 1316926983
- **Authorized official:** MR. RONALD J ROBERSON (CFO)
- **Authorized official phone:** (712) 279-5850

## Contact information

- **Practice address:** 801 5TH ST, SIOUX CITY, IA 51101-1394
- **Practice address phone:** (712) 279-2548
- **Mailing address:** PO BOX 1463, SIOUX CITY, IA 51102-1463
- **Mailing address phone:** (712) 279-2263

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 103TC2200X | Clinical Child & Adolescent Psychologist | — | NULL | Yes |
| 103TC2200X | Clinical Child & Adolescent Psychologist | — | — | Yes |

## Other

- **Enumeration date:** 01/12/2006
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0290858 | — | IA |
| 01 | — | 29085 | WELLMARK | IA |