Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Frederick Douglass Staten, PHD, LPC, CADCIII

Individual provider Professional Counselor · NPI 1417216730

Frederick Douglass Staten, PHD, LPC, CADCIII is a Mental Health Counselor in Portland, Oregon. Qualified in 2011, 15 years ago. Licensed in Oregon and Washington.

Years since qualifying
15
Licensed in
OR, WA
In the registry since
2012
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.
LPC — Licensed Professional Counselor
A licensed mental health counsellor.

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Practice location Address checks out

10920 SW Barbur Blvd
Portland, OR 97219-8600
Phone: (503) 244-4500
Fax: (503) 244-2008
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Professional Counselor (primary) Taxonomy 101YP2500X · Licence C4765 (OR)
Professional Counselor Taxonomy 101YP2500X · Licence LH60296096 (WA)
Addiction (Substance Use Disorder) Counselor Taxonomy 101YA0400X

Record details

NPI number1417216730
Entity typeIndividual (Type 1)
GenderMale
Credentials PHD , LPC , CADCIII
Sole proprietorNo
NPI enumeratedMay 7, 2012
Last updated in NPPESMarch 13, 2026
Certification dateMarch 13, 2026

Medicare enrollment

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

Medicare specialtyMENTAL HEALTH COUNSELOR
Medical schoolOTHER
Graduated 2011 (15 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

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