Mia Jasmine Copeland-Brock, APRN

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

RN2313693 Issued in MA

Practice address

165 Main St
Medway, MA 02053-1584

Phone

(508) 321-3210

Fax

(508) 321-3210

NPI assigned

Sep 23, 2022

Last updated

Jun 17, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Behavioral Health Network Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Springfield, MA
  • NPI 1477582609
  Medicare reassignment NPD
• Behavioral Health Network, Inc

  • Methadone Clinic
  • Springfield, MA
  • NPI 1669017653
  NPD
• Greater Boston Psychiatric Services, LLC

  • Adult Mental Health Clinic/Center
  • Medway, MA
  • NPI 1841643699
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1663891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750118400000",
    "number": "1174246128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "417 LIBERTY ST",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011043736",
            "telephone_number": "413-246-9675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "165 MAIN ST",
            "city": "MEDWAY",
            "state": "MA",
            "postal_code": "020531584",
            "telephone_number": "508-321-3210",
            "fax_number": "508-321-3210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COPELAND-BROCK",
        "first_name": "MIA",
        "middle_name": "JASMINE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-23",
        "last_updated": "2025-06-17",
        "certification_date": "2025-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MA",
            "license": "RN2313693",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MA",
            "license": "RN2313693",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rachael Coffin, LMHC, LPC
• Heather Marie Cohen
• Debra L. Cohn, D.O
• Wendy J. Collins, M.D.
• Robert L Cooper, MD
• Lucia Coplan, MSOT
• Kara B. Corley V, CCC-SLP
• Kayla Corshia
• Christa Cosmo, PA-C
• Cristian Petcu DDS PC (Smiles and more)

• Psychiatric/Mental Health Nurse Practitioner in Medway, MA
• Providers in Medway, MA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2025; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.