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Jay D. Fellers, LCSW PC 6021 South Syracuse Street, Suite 210 Greenwood Village, CO 80111 3039474071 (f) 3037793341 LCSW hushmail.com www.fellerstherapy.comCLIENT INFORMATION Client Name Date Of Birth:
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Fellers LCSW PC is a professional corporation owned by a licensed clinical social worker.
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The owner of Fellers LCSW PC is required to file the necessary documents.
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Filling out Fellers LCSW PC involves providing information about the corporation, its ownership, and relevant financial data.
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The purpose of Fellers LCSW PC is to operate as a professional corporation for a licensed clinical social worker.
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Information such as financial records, ownership details, and any relevant business activities must be reported on Fellers LCSW PC.
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